Appeals Specialist

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Date: Mar 18, 2023

Primary Location: Dover, NH, US

Company: Lincoln Financial

Alternate Locations: Work from Home

 

Work Arrangement:

Hybrid/Flexible : Work at home and use the office as appropriate for in-person collaboration.

 

Relocation assistance:  is not available for this opportunity.

 

Requisition #: 71242

 

The Role at a Glance

We are excited to bring on an Appeals Specialist to join our Appeal Review Department in a fully remote environment.  Appeal Specialists conduct reviews, investigation, and analysis of an assigned caseload of Group Disability and Life appeals.  The role is responsible for interpreting and applying correct contract terms/provisions, ERISA requirements, statutory guidelines, and case management and appeal procedures to each claim. 

 

Background Details
As an Appeals Specialist you will be responsible for being a product subject matter expert to provide full, fair appeal reviews for multiple product lines. This role requires extensive interaction with claimants, policyholders, attorneys, medical professionals and other relevant third parties throughout the duration of an appeal review.  As well as, the requisite technical skills, the ideal candidate will demonstrate excellent communication skills, the ability to multi-task, diffuse conflict diplomatically, embrace change and introduce creative and innovative solutions to manage the Appeal review process more efficiently and effectively. 
If this sounds like a role for you, please read on!

What you'll be doing

  • Independent analysis and investigation of STD, LTD, Life (Waiver of Premium and Accidental, Death & Dismemberment) appeals and take appropriate action pursuant to contractual provisions and legal requirements. 
  • Manage initial appeal submission, documentation, and correspondence, involving products with multiple funding arrangements. 
  • Manage appeals with diverse medical conditions, while using internal resources to evaluate accuracy, eligibility, and initial liability decisions. 
  • Maintain communication regarding the appeal process with claimants, attorneys, and employers, and manage ongoing expectations throughout the appeal process.
  • Establish and follow through on appeal workflow based on case facts, appeal procedures, regulatory requirements, and available resources.  
  • Delivers routine work independently, in accordance with established procedures and guidelines, in a timely manner and meets appropriate deadlines (ERISA & NonERISA). 
  • Makes routine and non-routine decisions, applying limited but increasingly more discretion within role except for matters of significance which affect the business as a whole or a significant part of it, in accordance with established procedures and guidelines.
  • Provides customer service to internal and/or external stakeholders, recognizes what needs to be done to meet customer needs and demonstrates flexibility and responsiveness to meet customer needs on routine work independently.
  • Recognizes issues or concerns for assigned area(s) of responsibility, explains effect on the customer's service experience, and suggests process improvements.
  • Carries out duties in compliance with all state and federal regulations and guidelines.  Complies with all company and site policies and procedures.

What we’re looking for

Must-have experience (Required):

  • 4 Year/Bachelor's degree or equivalent work experience (4 years of experience in lieu of Bachelor's)
  • 3+ Years’ Experience managing STD, LTD or a combination of claims that directly aligns with the specific responsibilities for this position (Required)
  • Ability to communicate effectively (verbal/written)
  • Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook)

 

Nice-to have Experience (Preferred):  

  • Experience working with multiple products
  • Presentation training or skills 
  • Demonstrates excellent organizational skills with the ability to prioritize workload and multi-task while maintaining strict attention to detail.

 

What’s it like to work here?

At Lincoln Financial Group, we love what we do. We make meaningful contributions each and every day to empower our customers to take charge of their lives. Working alongside dedicated and talented colleagues, we build fulfilling careers and stronger communities through a company that values our unique perspectives, insights and contributions and invests in programs that empower each of us to take charge of our own future.

 

What’s in it for YOU:

  • A clearly defined career framework to help you successfully manage your career

  • Leadership development and virtual training opportunities

  • PTO/parental leave

  • Competitive 401K and employee benefits

  • Free financial counseling, health coaching and employee assistance program

  • Tuition assistance program

  • A leadership team that prioritizes your health and well-being; offering a remote work environment and flexible work hybrid situations

  • Effective productivity/technology tools and training

 

Pay Range: $51,900 - $89,800 

 

Actual base pay could vary based on non-discriminatory factors including but not limited to work experience, education, location, licensure requirements, proficiency and qualifications required for the role. The base pay is just one component of Lincoln’s total rewards package for employees.  In addition, the role may be eligible for the Annual Incentive Program, which is discretionary and based on the performance of the company, business unit and individual.  Other rewards may include long-term incentives, sales incentives and Lincoln’s standard benefits package.

 

About The Company

Lincoln Financial Group, a Fortune 200 company with over 10,000 employees, provides advice and solutions that help empower Americans to take charge of their financial lives with confidence. Our core business areas — Life Insurance, Annuities, Retirement Plan Services and Group Protection — focus on supporting, preserving and enhancing over 17 million customer’s lifestyles and retirement outcomes.

Headquartered in Radnor, Pennsylvania, Lincoln Financial Group is the marketing name for Lincoln National Corporation (NYSE: LNC) and its affiliates. The company had $324 billion in end-of-period account values as of June 30, 2021.

Ranked one of the Best Large Employers in America and Best Employers for Women by Forbes magazine as well as one of Newsweek’s Most Responsible Companies, Lincoln Financial Group makes a serious investment in our employees’ futures through a broad range of wealth accumulation and protection plans, health and wellness programs, and career development resources designed to help each individual reach their personal and professional goals.

 

Lincoln is committed to creating a diverse and inclusive environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. 

 

Lincoln Financial Group is a committed corporate citizen included on major sustainability indices including the Dow Jones Sustainability Index North America and FTSE4Good. Dedicated to diversity and inclusion, we earned perfect 100 percent scores on the Corporate Equality Index and the Disability Equality Index. Follow us on Facebook, Twitter, LinkedIn, and Instagram. Sign up for email alerts at http://newsroom.lfg.com

 

Be Aware of Fraudulent Recruiting Activities

If you are interested in a career at Lincoln, we encourage you to review our current openings and apply on our website. Lincoln values the privacy and security of every applicant and urges all applicants to diligently protect their sensitive personal information from scams targeting job seekers. These scams can take many forms including fake employment applications, bogus interviews and falsified offer letters.

Lincoln will not ask applicants to provide their social security numbers, date of birth, bank account information or other sensitive information in job applications. Additionally, our recruiters do not communicate with applicants through free e-mail accounts (Gmail, Yahoo, Hotmail) or conduct interviews utilizing video chat rooms. We will never ask applicants to provide payment during the hiring process or extend an offer without conducting a phone, live video or in-person interview.  Please contact Lincoln's fraud team at fraudhotline@lfg.com if you encounter a recruiter or see a job opportunity that seems suspicious.

 

Additional Information

This position may be subject to Lincoln’s Political Contribution Policy.  An offer of employment may be contingent upon disclosing to Lincoln the details of certain political contributions. Lincoln may decline to extend an offer or terminate employment for this role if it determines political contributions made could have an adverse impact on Lincoln’s current or future business interests, misrepresentations were made, or for failure to fully disclose applicable political contributions and or fundraising activities.

 

Any unsolicited resumes/candidate profiles submitted through our web site or to personal e-mail accounts of employees of Lincoln Financial Group are considered property of Lincoln Financial Group and are not subject to payment of agency fees.

 

Lincoln Financial Group (“LFG”) is an Equal Opportunity employer and, as such, is committed in policy and practice to recruit, hire, compensate, train and promote, in all job classifications, without regard to race, color, religion, sex (including pregnancy), age, national origin, disability, sexual orientation, gender identity and expression, Veteran status, or genetic information.  Applicants are evaluated on the basis of job qualifications.  If you are a person with a disability that impedes your ability to express your interest for a position through our online application process, or require TTY/TDD assistance, contact us by calling 260-455-2558.

 

This Employer Participates in E-Verify. See the E-Verify notices.

Este Empleador Participa en E-Verify. Ver el E-Verify avisos. 


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